Evolution of the Healthcare Contact Center

Session 52, February 12, 2019

Lynne Hildreth, Director of Patient Access, Moffitt Cancer Center

Lynne Hildreth

Has no real or apparent conflicts of interest to report.

Conflict of Interest

• Learning Objectives

• 15 minutes of presentation – Moffitt Cancer Center and the impact

of the Patient Contact Center

• 35 minutes of Audience Conversation

Agenda

• Define primary roles of the healthcare consumer contact center

• Identify research-based metrics used to measure contact center

performance

• Discuss pre-registration information needed to facilitate an

express check-in at admission

• Describe technology used to monitor patient interactions in the

contact center

• Assess the role of the contact center in increasing pre-service

collections

Learning Objectives

Role of the Contact Center

• Consumer expectations

– High availability

– Seamless service

– 24/7 support

“Revenue cycle call centers must be flexible, fast and

versatile to meet patient expectations and market

shifts.”

"The Current State of the Revenue Cycle Call Center.” Revenue

Cycle Analytics, 2018, Issue 1. Healthcare Business Insights.

Evolving Consumer Expectations

Healthcare Patient Communication

Black

Hole

Black

Hole

“Please hang up and call 911”

• First stop in the consumer experience

• Set the tone for the entire patient encounter

• Often-untapped opportunity to build patient loyalty and brand

awareness

Healthcare Contact Center

• 21 clinical programs focused on disease groups (breast, GYN,

lung, GI, skin, etc.)

• Highly specialized, multi-disciplinary approach attracts patients

from throughout Florida and the country, particularly for rare

cancers

• In the process of making a cultural shift from Provider-First to

Patients-First

My Organization: Moffitt Cancer Center

3 Locations

in Tampa, FL

Moffitt Revenue Cycle

Revenue Integrity

Health

Information

Management

Moffitt Medical

Group

Patient Access

Patient

Financial

Services

700 team members, 5 key departments

Contact Today at Moffitt

813-745-8000

Patient

Care

Hotline

Patient

Care

Hotline

Mobile App

My Moffitt

Communication

RN’s of the Day

(Rotations in

Each Department)

Patient

Billing, Appointment Center,

HIM, etc.

• Resolve

• Start Secure Message

• Escalate

Voicemail

1986 - 2018

Portal

• Commitment to efficiency, quality

and reimbursement optimization

• Integrated scheduling,

preregistration, and insurance

verification

• Single point of contact to schedule

an appointment at any Moffitt clinic,

lab or radiology facility

Moffitt’s Principles for Patient Access

• Front End

– Facilitating streamlined access to services: Scheduling

– Improving consumer experience: Patient Answer Center

– Validating coverage to prevent denials: Financial Clearance

– Improving quality of patient registration and billing data: Pre-reg

– Increasing front-end payment

– Reducing appointment no-shows and referral leakage: Reminders

• Back End

– Billing/Account Servicing, Guarantor Collections

• Other

– Clinical?

– Medical records: Release of Information

– Portal / technical support line

Primary Roles / Key Functions

• Forward-thinking health systems centralizing to streamline

scheduling, pre-registration, billing and collections

• Signs point to a one-touch option for patients in the future –

eliminate the front-end/back-end division

– Options to set up payments plans

– Price estimation

Centralization

Metrics

• Peter Drucker:

“What gets measured gets managed - even when it's

pointless to measure and manage it, and even if it harms

the purpose of the organization to do so.”

• >100 metrics in our ACD system

• Workforce Management (WFM) introduces dozens more….

Research-Based Metrics

Getting the Level of Detail is Critical

So what?

• Should you present them together?

Historical vs Real Time Metrics

• Focus… perhaps create one of each

– Department metric

– Team metric

– Individual metric

• People don’t like math! Watch your decimal places – consider not

just the metric but the presentation of the metric.

• Averages vs. Medians

How do you choose?

• Choose one metric

• Quality – Accuracy – Service – “hard items” and “soft items”

• Net Promoter Score?

• Volumes – what matters?

• Average Handle Time vs. Production Metrics

Performance Metrics to Consider

Metric Definition Advantages Disadvantages

Abandonment

Rate

% of Callers which hung up

prior to reaching an agent

• Easy to explain /

understand

• Easy to benchmark

• A caller that won’t hold at all

(repeated call backs) can skew

the rate.

• Needs sufficient volume (n >

500 calls?).

Service Level % of Calls which were

answered within ___ seconds

• Removes outliers

(those who won’t wait

for even a few seconds)

from your metric

• Difficult to grasp / relate to.

• Variety of # of seconds used

makes benchmarking difficult.

Hold Times Average time a caller waits

on hold prior to reaching an

agent

• Easy to explain /

understand

• Benchmarks are less available

(can vary widely by type of

business) – relationship of call

duration vs hold time is

Role of Technology

• At Moffitt:

– Knowledge Base and Digital Algorithms: Cannot expect

agents to rely on their memory and experience

– Call recording – voice and screen capture

– ACD – skillsets, call routing, real-time reporting

– Patient Portal

– Faxing engine (sigh!)

Technical Approach

• ACD skillsets – dedicated outbound agents and inbound “pods”;

get benefits of centralization while retaining expertise of

decentralized approach

• Multi-channel communication strategy: seamless service and

accountability

– Email; Portal; Live chat (with AI?)

• Outstanding service via the patient portal to drive business there

• Digital Audit Trail

Secrets to Patient Communication

• Quality Assurance

– Call recording and scorecards for quality monitoring

– Metrics for accuracy/comprehensiveness of transcription

• Quality Review Process

– Supervisors perform first level review

– Quality Review team performs secondary review

• More QA tools

– Audio search checks recordings for key words

– Screen recording matches on-screen activity with recordings

Voice Recording/QA

• One location for all recordings from scheduling to pre-registration

to contact center to billing/collections

– Digital audit trail of patient interactions

– Valuable data to improve consumer experience

• Corresponding faxes/electronic records

– Moved clinic’s faxes to centralized electronic faxing engine

– Send records, move to worklist based on assigned clinic

– Clinic checks records and uploads to patient’s chart

Continuity in Communication

A Special Word on Phone Setup

Moffitt Care Hotline

813-745-8000

• Caller ID masking is

critical

Pre-Service Collections

• Pre-service collection – at time of:

– Scheduling?

– Pre-registration?

– Financial counseling?

• Price Estimation

– Is it a pre-requisite to up-front

collections?

– How accurate must it be?

• Patient Financing Programs

– Is this a pre-requisite to up-front

collections?

– Do you stand to lose more than

you gain without one?

Where does up-front collection fit in?

• Do you believe the benefits afforded by a contact center outweigh

the downsides? Does a contact center truly reduce costs or

increase revenue/collections?

• What metrics do you think are the most valuable for a contact

center? What is the best way to present metrics?

• What technologies could further enhance the contact center?

• What is the best way to introduce pre-service collections? Is price

estimation necessary? Patient financing programs?

• What cultural, technical or other challenges can you see in trying

to implement a contact center in your setting?

• While it wasn’t covered in the presentation, what best practices for

recruiting, training and retention?

Audience Conversations

Lynne Hildreth

lynne.hildreth@moffitt.org

813-745-6795

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